<html>
	<body>
		<table>
			<tr>
				<td width='1'></td>
			</tr>
			<tr>
				<td colspan='2' rowspan='2'></td>
			</tr>
			<tr>
				<td rowspan='2'></td>
			</tr>
			<tr>
				<td colspan='2'>
					<table>
						<tr>
							<td></td>
							<td>
								<input type='text' />
							</td>
						</tr>
					</table>
				</td>
			</tr>
		</table>
	</body>
</html>